Health Sciences Overview

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Health Sciences Practice

BSI’s strong team of domain and technology experts cater to the changing needs of

the Medical Diagnostics and Analytical equipment companies

Analytical Instrumentation

! _{Lab Instruments}

! _{Soft Control Panels} ! Data Acquisition

! _{Data Analysis,Graphs}_etc ! _Compliance

! 21 CFR Part 11

Diagnostics Imaging

! _{Diagnostic Imaging}

Application -

Ultrasound, MRI, PET, SPECT

! _{Core Image processing} Algorithm development ! _{Integration of third} party algorithms

Health IT

! PACS/RIS Solutions ! _{PMS / EMR} ! _{Communication} standards ! DICOM ! HL7

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Health Sciences - Team Structure

Image Processing

Consulting Radiologist/ Clinician etc.

Health IT (PACS/RIS)

Health IT (EMR)

RESEARCH

INSTITUTES COMMUNITIESACADEMIC FRATERNITYMEDICAL

HEALTH SCIENCES PRACTICE

TECHNICAL TEAM DOMAIN CONSULTING GROUP

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Representative Profile (Image Processing Consultant)

!

_{Ph. D (Biomedical Engineering)}

Indian Institute of Technology Bombay (2008)

!

_{Ph. D Thesis}

Function Diffused optical tomography for Neonatal brain functional monitoring.

!

_{Imaging expertise}

!

_{Medical image processing algorithms}

!

_{Image Analysis}

!

_{Tomographic image reconstruction algorithms}

!

_{Signal processing (Especially medical signals)}

!

_{Projects Experience}

!

_{Research and Development of Segmentation algorithm for Features from}

CTA Data

!

_{Development of Diffuse Optical Tomography (DOT) image reconstruction}

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Representative Profile (Radiologist)

!

_{M.D. (Radiology)}

!

_{Consultant radiologist with well known diagnostic centers in Mumbai}

!

_{Experience in consulting and Ground Truth (GT) generation for Imaging R&D}

projects.

!

_{Modalities experience include}

!

_{Multidetector Spiral CT scan}

!

_MRI

!

_{Ultrasonography and Color Doppler}

!

_Mammography

!

_Publications

!

_{Imaging in Mesenteric ischemia on multi-detector CT scan}

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Representative Profile (Health IT Consultant)

!

_{Master of Science (Biomedical Engineering)}

!

_{University Of Michigan, USA}

!

_{Providing adequate subject matter expertise/domain knowledge in areas such as}

PACS, EMR and Endoscopy

!

_{Project Experience}

Thorough knowledge of PACS (Picture Archiving and Communication Systems),

DICOM (Digital Imaging and Comm. in Medicine), HL7 (Health Level 7) and IHE

(Integrated Health Enterprise).

ENTERPRISE WIDE PACS

!

_{Experience in working with a top PACS provider for building their enterprise wide}

PACS platform.

SPECIALTY PACS

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BSI Diagnostic Imaging expertise - Snapshot

! About 10 years domain experience

! 350 Man years experience on a variety of projects

! A dedicated team of more than 60 engineers

! Dedicated Imaging group comprising of

! _{Technical team specialized in imaging software development}

! _{Consulting Image processing experts from research institutes and academic community}

! Imaging algorithm development / implementation for different modalities such as MRI, Ultrasound, PET and SPECT

! Experience in evaluation and Integration of third party algorithms and libraries in a vendor neutral manner for quick time to market

! _{Wide experience in implementing Enterprise wide and Specialty PACS}

! _{Worked with leading companies such as Hitachi Medical Corporation, Gamma Medica,}

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Diagnostic Imaging Workflow

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BSI Positioning

BSI

Expertise

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BSI Services

! _{Collaborative Product Development}

! Console application development for medical imaging modalities – MRI, PET and Ultrasound

! Image acquisition application - SPECT

! _{Development of 2D & 3D Image processing algorithms and imaging libraries.}

! _{Developing smart and user-friendly User Interfaces for imaging modalities. Building Ease of}

operation with the use of operator guidance modules

! Patient Information Management System applications

! _{PACS solutions – Enterprise and Specialty}

! _{Networking solutions in the area of image management (PACS solutions)}

! _Enhancement

! Performance optimization for special purpose processors

! Re-engineering

! _{Re-engineering legacy systems using Commercial-Off-The-Shelf Hardware and Software}

technologies

! _{Migration of Software across platforms, operating systems} ! Sustenance

! Compliance

! _{Incorporating IHE compliance in modality consoles} ! _{Implementation and testing for DICOM compliance} ! _{21CFR Part 11compliance for medical equipment}

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Image Acquisition - SPECT

!

_{Imaging technique based on detection of}

gamma rays

!

_{Radionuclide injected to the patient.}

!

_{Multiple projections (2D images)}

acquired from multiple angles using

gamma cameras.

!

_{Possible to reconstruct 3D data using}

tomographic reconstruction algorithm.

!

_{Cardiac and Respiratory gated}

acquisitions possible.

!

_{Use of multiple gamma cameras (2, 4}

etc) provide accelerated acquisition.

SPECT Projection SPECT Projection SPECT Reconstructed SPECT Reconstructed data data

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Post Processing – MRI, Ultrasound

!

_{Post Processing of Images}

!

_{Image 2D Tasks}

!

Diffusion, Perfusion

!

Add/Sub – Addition, Subtraction of

Images

!

Dynamic Analysis- Analysis over time

!

Velocity Analysis – Analysis of Velocity

changes

!

Filter – Application of various 2D Filters

!

Tissue Tracking – Motion tracking of

tissues

!

Contour Processing

!

_{Image 3D Tasks}

MIP Perfusion

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Image Processing Algorithms

!

_{Algorithms for Image Processing}

BSI has worked on several Medical Imaging Algorithms (2D/3D)

!

Maximum Intensity Projection (MIP)

!

Multi Planer Reformat (MPR)

!

Volume Rendering

!

Addition and Subtraction

!

Automatic Contour / Edge detection

!

Automatic Motion Tracking

!

Region Growing

!

Image Filtering

!

Statistical Analysis

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!

_{Algorithms for Image Processing}

!

_{Used third party software called as Cedara IAP library for implementing 3D}

image processing algorithms

!

_{Thorough understanding of the IAP system architecture and various objects the}

library exposes

!

_{Design of complex IAP pipelines (using IAP objects) and implementation of 3D}

functionalities such as

Maximum Intensity Projection, Multi Planar Reformat,

Volume Rendering (both parallel and perspective), Virtual Endoscopy and 3D

filtering.

!

_{Used LCModel for spectroscopy analysis}

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Visualization & Analysis

!

_{Image Visualization and Analysis}

BSI has worked on

! _{2D and 3D Image Rendering}

! _{Framework for interactive drawing of 2D ROIs}

! _{Interactive image manipulation (Zoom, pan, rotate etc)}

! _{ROI based image processing}

! _{Statistical measurements (e.g Volume)}

ROIs, Image Analysis on MRI

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Patient Information Management

!

_{Patient Information Management}

! Patient Registration and Patient Directory

! _{Common Framework for Patient data management within the medical} application

! _{Examination Window and Process Management Framework} ! Database specific functionalities for Patient data storage

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PACS

ENTERPRISE WIDE PACS

!

_{Experience in working with a}

top PACS provider for

building their enterprise wide

PACS platform.

SPECIALTY PACS

!

_{Experience in specialty}

PACS system, targeted

towards a very specific

audience of the medical

fraternity

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PACS …contd

!

_{Our Experience}

!

Web based architecture to support multiple medical facilities and mobile

physicians

!

Imaging viewers for multi departments/modalities within the enterprise

!

Lossy & Lossless image compression techniques for smart storage of data

as per customer requirements.

!

Smart image streaming techniques for faster image display on low bandwidth

connections

!

Synchronization of images and information across multiple servers across

multiple facilities for real time data access

!

Integrated 3D tools, including Comparative MPR/MIP/Oblique Slice

!

License managements tools

!

Integrated SAN support

!

Available off-site archive/disaster recovery service

!

Support for multiple file types (DCM, JPEG, MPEG, AVI, PDF, TIFF,

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PACS …contd

!

_{Our Experience}

!

Speciality orthopaedic planning tools and their integration with PACS

!

Excellent understanding of the orthopaedic workflow

!

Developed API’s for integrating third party products and web portals

!

Automatic propagation of viewer/tools updates to PC viewing/reading stations

!

EMR integration

!

Excellent GUI design and usability

!

Integration with OR devices (endoscopy)

!

Excellent understanding of the radiology workflow (Worklist, Dictation,

Transcription and Reporting)

!

Data migration projects from one PACS vendor to another

!

Mobile services for the physician including image review and preliminary

diagnostics

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Communication Standards

DICOM is focused at

‘Imaging’ i.e. communication of Image data and the

relevant information within the hospital.

HL7 is focused at “textual” structured (Non Image) information exchange within the hospital.

HL 7 and DICOM are not competing standards but they co-exist to achieve complete Enterprise Integration

COMMUNICATION STANDARDS

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DICOM Expertise

!

_{Verification Service Class}

o _{C-Echo service for SCU (Service} Class User)

o _{C-Echo service for SCP (Service} Class Provider)

!

_{Storage Service Class}

o _{C-Store service for SCU} o _{C-Store service for SCP} !

_{Query / Retrieve Service Class}

o _{C-Find service for SCU} o _{C-Find service for SCP} o _{C-Move service for SCU} o _{C-Move Service for SCP} !

_{DICOM Print Services}

! _{Modality Worklist Management (MWM)}

! Modality Performed Procedure Step (MPPS)

! Media Storage – Part10 file, Archive etc.

IHE – Integrating Healthcare Enterprise

! Integration Profiles for Acquisition Modality

o _{Scheduled Workflow (SWF)}

o _{Patient Information Reconciliation (PIR)} o Consistent Presentation of Images (CPI)

! _{DICOM compliance testing prescribed by IHE}

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HL7 Support

ADT Integrated Hospital Information Processing System Patient

Registration ORM Radiology

Message Purpose

ADT/ACK_A01 Patient Admit Message ADT/ACK_A02 Patient Transfer Message ADT/ACK_A03 Patient Discharge Msg.

ADT/ACK_A06 Transfer Out-patient to In-patient ADT/ACK_A07 Transfer In-patient to Out-patient ADT/ACK_A08 Update Patient information

ADT/ACK_A11 Cancel Patient admission ADT/ACK_A12 Cancel Patient transfer ADT/ACK_A13 Cancel Patient discharge

ORM/ACK_O01 General Order Message (Creation of Radiology request)

ORU/ACK_O01 Unsolicited Transmission of Observation Message

!

_{Communication between HIS &}

RIS applications

!

_{Data exchanged by sending/}

receiving the HL7 messages

!

_{Messages used:}

o Admission, Discharge & Transfer messages

o _{General Order messages}

o _{Unsolicited transmission of an}

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Technology Expertise

Processor Architectures Intel x86, Intel i960, Motorola 68K, Motorola PPC, ARM7, ARM9,

MIPS R3000

Platforms Windows, Unix, Solaris, HP-UX, Linux

File Formats (Imaging) DCM, JPEG, BMP, etc.

Embedded Operating Systems VxWorks, pSOS+, Embedded Linux, eCOS, MQX, CMX, OSE,

Windows CE, mC/OS

Languages C/C++, Java, C#, VB.Net, eVC++, Managed C++

Software development tools Visual Studio .Net, Eclipse, Java, Sun Studio, J2SE, J2ME, GNU, Compact .NET

Other Tools Rational Rose, UML, Rational XDE (for design documentation), nUnit (for unit testing), .NET Memory Profiler, Ants Profiler (For Performance), Visual Source Safe (for version control),

ClearQuest (for defect tracking)

3rd Party Software Cedara IAP Server (for image processing)

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Client

The client is one of the world’s largest manufacturers & sellers of medical electronics equipment

The Need

! Development of a single user-friendly operator console for multiple modalities (MRI, CT, PET).

! Additional features to increase customer satisfaction levels

BSI’s Role

! _{Applications of the Operator console included}

Patient Registration, Patient Directory,

Examination Window, Scan Management, Image Processing, Image Review, Filming / Printing

Technology

! _{. NET(VB .Net, C#, Managed C++), Cedara IAP}

Server, Merge (DICOM library)

! _{Rational XDE, Visual source safe/clear case,}

Bugzilla/clearquest

Development of operator console for Multiple Modalities

Benefits to the Client

! The generic framework enabled the support for different imaging modalities. This significantly reduced the

development time required for

developing console application for other modalities.

! _{Various innovative features not}

supported by the competition were added to the product, giving the client a competitive edge

! _{BSI’s collaborative development model}

ensured seamless functioning with the client and its partner vendors resulting in timely completion of the project.

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Client

The Need

! Development of a Modality console application consisting of various post-processing tasks such as Maximum Intensity Projection (MIP), Multi Planar Reformat (MPR), Volume Rendering (VR) and many others.

! _{All these tasks involved implementing various image} processing algorithms operating on a plain (single) image (2D processing) / (3D processing).

BSI’s Role

! 3D image processing algorithms implementation using Third Party Libraries

! _{Design of complex IAP pipelines (using IAP objects)} and implementation of 3D functionalities such as MIP, MPR, VR (both parallel and perspective), Virtual

Endoscopy and 3D filtering.

! _{Also involved in various 2D image processing tasks} such as Addition/Subtraction of images, Perfusion, 2D Filtering tasks.

2D and 3D Image Processing

Technology

! .Net (VB .Net, C#, Managed C++)

! _{Plug-in architecture allowed easy}

replacement of third party software components

Edge Enhancement

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Client

The client is one of the world’s innovative manufacturers of next-generation imaging systems for both clinical and pre-clinical applications

The Need

! _{Development of a standalone image acquisition}

application (for SPECT Modality) that would display real time projection images.

! _{This also required implementation of various image}

acquisition protocols such as Static, Dynamic and Tomographic etc including the gating signal support.

BSI’s Role

! _{A team of domain specialists and architects from}

BSI worked very closely with the client in the initial phases to gain complete understanding of the SPECT imaging concepts to formulate the software requirement specification in a very short time

! _{BSI used the SPECT image generation algorithm for}

acquisition and creation of the projection image.

SPECT Image Acquisition

! _{Implementation of a scalable &} re-usable architecture with efficient Object Oriented design enabled the client to enhance the application with new features for patient data management and image reconstruction in a short

Technology

VC++, .NET

SPECT Projection Image

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Client

The Need

! An application for creating a user-friendly display of strain and the torsion data using the latest and easily available display forms.

! Enhance the tracking techniques and fasten the data processing.

BSI’s Role

! _{BSI designed a user-friendly MDI application with}

the following features:

! 4 different types of views

! Saving the color view as motion files

! ROIs comprising of two equidistant co-axial &

similar shapes.

! Manipulations of ROIs

! Tracking of a large number of point-pairs on the

frames of motion file and displaying the data analyzed in the color view.

Colour Tissue Tracking

Technology

! _{VC++ 5.0/MFC}

! The re-usable components resulted in saving time and cost

Fig (1) Marked ROI

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Client

The Need

! The application required compliance with IHE framework and DICOM standard support. It involved the following

! Implementation of IHE profiles, DICOM and

Non-DICOM storage and retrieval, Non-DICOM Format Conversion, Private tags etc.

! Testing using MESA Server

BSI’s Role

! _{Understanding of existing application features, its}

merits and shortcomings, requirements of the new application and the end user perspective.

! _{Design of a robust and flexible architecture for the}

application and implementation using .NET technology.

DICOM compliance in Modality Console Application

Technology

! _{Addition of new features}

! _{Faster development of the application} ! Faster regression testing due to

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Client

The client is one of the world’s largest

manufacturers & sellers of medical electronics equipment.

The Need

Patient Information management solution for easy information access

BSI’s Role

! The features supported by the BSI solution included the following:

! Patient Registration

! Emergency Patient Registration and

reconciliation

! Accessing Patient Information from Hospital

Information System

! Examination scheduling

! Patient data including Examination reports

storage, archival and retrieval.

! Advanced search facilities to Search Patient

information

Patient Information Management

Technology

! _{Seamless integration with other}

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Why BSI?

!

_{Relevant Competencies enabling quick transition (Domain, Technical)}

! _{Well networked with Image processing consultants, Radiologist/Clinicians, Health IT(PACS,EMR)}

experts from research institutes, academic community and medical fraternity.

! _{Imaging algorithm development / implementation for different modalities such as MRI, Ultrasound,}

PET and SPECT

! _{Have clinical experts who work on ground truth generation using patient data for algorithm}

validations.

!

_{Cost-effective, process-based engagement models}

! _{Reduce Time-To-Market}

! _{Lower TCO}

! _{Stringent security policies and measures to prevent IP leakage}

!

_{Global Product support}

!

_{Value Added Benefits}

! _{Improve Quality by usage of industry’s best practices}

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